Arthroscopic Labral Repair for Instability

Who is a candidate?
Labral repair is recommended for patients who experience shoulder instability—when the shoulder repeatedly slips, feels loose, or dislocates. This is often due to a Bankart tear, where the labrum (the rim of cartilage that helps keep the ball centered in the socket) is torn after a dislocation. Young, active patients and athletes are at higher risk for ongoing instability, and surgery may be considered if the shoulder continues to dislocate or feels unreliable despite non-surgical treatment.

What does the surgery involve?
Labral repair is performed arthroscopically using small incisions and a camera. The torn labrum is carefully reattached to the rim of the socket with small anchors and sutures. This restores the “bumper” effect of the labrum, making the socket deeper and helping the shoulder stay stable. Sometimes, stretched ligaments are also tightened to reinforce stability.

How is this different from shoulder replacement?
Labral repair preserves the natural joint surfaces and is focused on restoring stability. Unlike shoulder replacement, it does not involve removing bone or cartilage. This makes it a good option for younger patients with instability but otherwise healthy joints.

What are the potential downsides or risks?
As with any surgery, there are risks of infection, stiffness, or pain. The main concern after labral repair is recurrent instability—especially in contact athletes or those with large bone defects. Rarely, patients may notice a slight loss of outward rotation, though this usually does not affect daily activities.

What is recovery like?
The arm is placed in a sling for the first few weeks to allow healing. Therapy begins with gentle, guided motion, then progresses to strengthening. Daily activities return gradually, with full return to sports typically at 4–6 months, depending on the demands of the sport and the individual’s healing.

What is a Remplissage?

In some patients, repeated dislocations cause a dent or groove in the ball of the shoulder (called a Hill-Sachs lesion). If this groove is large, it can catch on the socket and make the shoulder more likely to slip out again.

A remplissage (French for “to fill in”) is an additional step that may be done during labral repair. In this procedure, a tendon from the back of the shoulder (infraspinatus) is anchored into the groove, “filling it in” and preventing the ball from engaging with the socket abnormally.

This added step can significantly reduce the risk of future dislocations, especially in high-risk patients. The trade-off is that it may slightly limit the ability to rotate the arm outward, but this is usually mild and does not affect most daily activities.